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Randomised controlled trial of intermittent versus continuous energy restriction during chemotherapy for early breast cancer

Harvie, M, Pegington, M, Howell, S, Bundred, N, Foden, P, Adams, J, Graves, LEF, Greystoke, A, Mattson, M, Cutler, R, Williamson, J, Livingstone, K, McMullen, D, Sellars, K, Lombardelli, C, Cooper, G, McDiarmid, S and Howell, A Randomised controlled trial of intermittent versus continuous energy restriction during chemotherapy for early breast cancer. British Journal of Cancer. ISSN 0007-0920 (Accepted)

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Abstract

Background
Excess adiposity at diagnosis and weight gain during chemotherapy are associated with recurrence and chemotherapy toxicity. We assessed the efficacy of intermittent energy restriction (IER) vs continuous energy restriction (CER) for weight control and toxicity reduction during chemotherapy.

Methods
172 women were randomised to follow IER or CER throughout adjuvant/neoadjuvant chemotherapy. Primary endpoints were weight and body fat change. Secondary endpoints included chemotherapy toxicity, cardiovascular risk markers, and correlative markers of metabolism, inflammation and oxidative stress.

Results
Primary analyses showed non-significant reductions in weight(-1.1 (-2.4 to +0.2) kg p= 0.11) and body fat (-1.0 (-2.1 to +0.1) kg p=0.086) in IER compared with CER. Predefined secondary analyses adjusted for body water showed significantly greater reductions in weight (-1.4(-2.5 to -0.2) kg p=0.024) and body fat (-1.1 (-2.1 to -0.2) kg p=0.046) compared with CER. Incidence of grade 3/4 toxicities were comparable overall (IER 31.0 vs CER 36.5%, p=0.45). With a trend to fewer grade 3/4 toxicities with IER (18%) vs CER (31%) during cycles 4-6 of primarily taxane therapy (p=0.063)

Conclusions
IER is feasible during chemotherapy. The potential efficacy for weight control and reducing toxicity needs to be tested in future larger trials.

Clinical trial registration ISRCTN04156504

Item Type: Article
Uncontrolled Keywords: 1112 Oncology and Carcinogenesis, 1117 Public Health and Health Services
Subjects: R Medicine > RC Internal medicine > RC0254 Neoplasms. Tumors. Oncology (including Cancer)
R Medicine > RC Internal medicine > RC1200 Sports Medicine
Divisions: Sport & Exercise Sciences
Publisher: Springer Nature
Date Deposited: 14 Oct 2021 06:42
Last Modified: 14 Oct 2021 08:00
URI: https://researchonline.ljmu.ac.uk/id/eprint/15642

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